Dynamics of Care in Society Professional Decision Making & Problem Solving

1. Dynamics of Care in Society Professional Decision Making & Problem Solving

2. Perceptions & Interpretations Impact our decision making & problem solving skills. There can be several interpretations of the same information.

3. What do you see??? GOOD or EVIL Is this woman old...or young?

4. The "illusion" is that this is just a picture of coffee beans; but it is not. Can you find a man's face among the beans? Some say that if you find the man in 3 seconds or less, the right half of your brain may be more well developed than most.

5. Whatyouread vs whatyousee A skull? Or a woman looking into a vanity mirror?

6. How many horses can you find in this picture? Most people can find 5…some experts say there are 7

7. Errors in Perception: • Pretending to know…deceiving yourself and others about what you know. • Resistance to change…opposing new ideas, because they are unfamiliar or uncomfortable. • Either/Or Thinking…taking only extreme positions for or against, seeing only black or white.

8. Objective 1 – Define critical thinking & discuss reasons why this is an essential skill for all health professionals. Critical Thinking The process by which we detect & analyze assumptions underlying our actions, decisions and judgments in our personal and professional roles. It is an essential skill for all health professionals.

9. Objective 2… • Identify and define underlying assumptions &/or problems regarding an issue, idea or phenomenon. • Objective 3… • choose appropriate methods of inquiry and or problem solving for addressing the issue, idea or phenomenon.

11. Features of Critical Thinking in Health Care • Purposeful & results-oriented • Based on principles of: • Health care practice • Scientific method • Evidence-based • Guided by professional standards & ethics codes • Self-correcting through constant reevaluation

12. When Critical Thinking We… • Differentiate between facts & opinions…. Facts are realities be able you can providea source for your information. Opinions are beliefs & judgments • Form opinions with great care & are willing to revise even cherished opinions, whenever they prove to be in error. • If you are unsure if it is fact or opinion…treat it as opinion.

13. Why is critical thinking important????? • Forces the development & evaluation of your thinking skills. • Allows you to probe beneath the surface. • Discovers the structure of your thoughts. • Develops critical listening skills. • Suspends judgment until there is enough sufficient evidence is found. • Allows you to explore opposing viewpoints.

14. Fair minded vs Unfair Minded • Listen before reaching a conclusion • No stereotyping • Consider ideas before automatically rejecting or accepting

15. Autonomy vs Conformity • Think for yourself • Analyze & evaluate beliefs & values • Know when to question and when to conform • Being open to necessary change or compromise

16. Perserverance vs Laziness • Dedicated & determined to find a solution • Research as needed • Look for the BEST not the quickest or easiest solution • Be willing to “monitor and adjust” as necessary

17. Creativity vs Not • Consider new solutions and ideas Humility vs Arrogance • Know the limits of your own knowledge • Ask for help, direction & support

18. Confidence vs Distrust • Have faith in yourself…your training, your knowledgeyour abilities, your strengthsyour self awareness, your limitations Integrity vs Deceit • Scrutinize your own knowledge & beliefs as you would other • Research and be able to support your thinking

20. Problem Solving vs. Decision Making 􀂃 Problem solving is a set of activities designed to analyze a situation systematically and generate, implement, and evaluate solutions. 􀂃 Decision making is a mechanism for making choices at each step of the problem-solving process. It is part of problem solving.

21. 5 Step Problem Solving • Identify the problem • Gather information & identify possible solutions • Select the best option • Implement the solution • Evaluate the results

23. Similar idea : Six steps to making an effective decision: • Create a constructive environment. • Generate good alternatives. • Explore these alternatives. • Choose the best alternative. • Check your decision. • Communicate your decision, and take action.

24. Strategies for improving problem solving & decision making: • Brainstorming: • This technique is used to encourage participation from each member of the team. • Brainstorming helps to break people out of the typical mode of approaching things to produce new and creative ideas. • It creates a climate of freedom and openness, which encourages an increased quantity of ideas.

25. 2. Root Cause Analysis (AKA as the "Five Why's."). The objective of Root Cause Analysis is to find the fundamental cause for a problem. Simply ask "Why?" five times or more to really get at the root of the problem.

26. Using the 5 Whys, you go through the following steps to get to the cause of the problem: • Why is our patient, Mr. Sick upset? Because we did not provide the test results when we said we would. • Why were we unable to meet the agreed-upon timeline? One new test ordered required more time before the results were available. • Why did it take so much longer? This is new test, and it had to be sent to an outside lab. • Why did we underestimate the time for the test results? Because we were not aware of the new procedures. • Why didn't we know this? Because we had not kept current with policies & procedures for certain tests. • Conclusion…We clearly need to stay current and communicate accurately about timelines for important patient information.

27. 3. Cause and Effect Diagrams. This diagram is drawn to represent the relationship between an effect (the problem) and its potential causes. The diagram helps to sort-out and relate the interactions among the factors affecting a process.

28. 4. Flowcharting a map that shows all the steps in a process.

29. 5. Think aloud… talk it through 6. Trial & Error… explain, explain in a different way, use a visual, pamphlet, interpreter , video…, ask open ended questions, provide calm atmosphere, change setting… 7. Use a problem solving group…teams bring richness of thought, an ownership of results and action when it comes to implementing solution

30. 8. Scientific Problem Solving • Problem or question • Research • Hypothesis formulation • Experiment • Collect & analyse data • Form conclusion based on results • Communicate results • 9. Intuitive Problem Solving • Based on inner prompting or instinct • No logical thinking • Identifying a solution to a problem based on its similarity or dissimilarity to other problems

31. 10. Decision Making Trees see handout • Look at Choices • Consider Factors of Influence(roots, trunk) • Suggest Appropriate Alternatives (lg. branches) • Consider Risks of choosing alternatives (sm. branches) • Choose Action to be taken • Critique Action

32. Decision Making Trees

33. 11. Decision Matrix: see activity A Decision Matrix is useful when faced with making a difficult decision. The options or alternatives are listed in the left-hand column and the selection criteria is listed across the top row. Each of the options are rated against the selection criteria to arrive at the best logical decision.

34. Activity: Decision Matrix: Example – Dog Bite Intervention Suppose that these four interventions have been brainstormed to address the high incidence of dog bites occurring in your tribal community. Using the decision criteria in the first column, how would you rate each intervention. Rating is low, moderate, or high. Answers will be different for each program and community. You should be able to justify each rating you give. Decision Criteria Passage of Getting rid of all dogs Electronic fencing Animal Control a Leash Law (home) to pick up strays Effectiveness Feasibility Cost Feasibility Sustainability Political Acceptability Social Will Unintended consequences Intervention Rating

36. 12. Working backwards… see ex. Ex. Leon wanted to know the age of a black bear at the zoo. The zoo keeper told Leon that if he added 10 years to the age of the bear and then doubled it, the bear would be 90 years old. How old is the bear? (Hint: Using the facts given, start with 90 years and work backwards.) Understanding the Problem · Did the zoo keeper tell Leon the bear's age? (no)· What was the last thing the zoo keeper did to the bear's age? (He doubled it.)· What was the first thing the zoo keeper did to the bear's age? (He added 10.) )

37. Finding the Answer Work Backwards Start with 90, the final number given by zoo keeper. Divide by 2 to get the number that was doubled—90 ÷ 2 = 45. Subtract 10 to get the age of the bear before 10 years was added—45 - 10 = 35 The bear was 35 years old.

38. PRACTICE Name(s) ____________________________________________ Practice Problem Decision Matrix: Example – Dog Bite Intervention Suppose that these four interventions have been brainstormed to address the high incidence of dog bites occurring in your tribal community. Using the decision criteria in the first column, how would you rate each intervention. Rating is low, moderate, or high. Answers will be different for each program and community. You should be able to justify each rating you give. Decision Criteria Passage of Getting rid of all dogs Electronic fencing Animal Control a Leash Law (home) to pick up strays Effectiveness Feasibility Cost Feasibility Sustainability Political Acceptability Social Will Unintended consequences Intervention Rating Practice problem- working backwards: Rabbits multiply at an amazing rate. In year 1 there are X rabbits. The rabbit population doubles each year. The forest is crowded in year 7 when there are 3200 rabbits. How many rabbits were there in year one if the population doubles each year?

39. Practice problem: Rabbits multiply at an amazing rate. In year 1 there are X rabbits. The rabbit population doubles each year. The forest is crowded in year 7 when there are 3200 rabbits. How many rabbits were there in year one if the population doubles each year?

40. Practice answer: Make a table and work backward from year 7 when there are 3200 rabbits. Since population doubles each year, working backward means halving it. There were 50 rabbits in year one.

41. Name __________________ Per ____ Date ___________ • Activity: Select one of the topics below then follow step 1-3 • Should everyone applying for a marriage license be tested for AIDS? • Do you favor a mandatory drug test for high school students? Step 1 - State your position on the issue. Explain what you’ve seen or learned that supports your thinking Step 2 - Seek other views & evidence. Briefly describe your findings, including references to your sources of information Step 3 - Decide which view is most reasonable. If need be, revise your position from Step 1. Explain any reasons for revising or not revising your original view.